Doctors are unhappy with the 48 hour target

The move is part of a drive to ensure all NHS patients have the opportunity to see a GP within two working days.

There is concern that official figures showing high levels of compliance with the government's two-day target do not reflect patients' actual experiences.

But critics argue that the new system will be of limited value because calls to GP surgeries will not be anonymous.

Doctors argue that the target has reduced their ability to prioritise patients according to clinical need.

Practices need to offer advance appointments - there must be no excuses or exceptions Lord Warner

Under the new system, primary care trusts (PCTs) will telephone surgeries on a random day every month to find out whether they are adhering to the two-day target.

Practices will be asked not only when their first free slot is available, but also their third, to assess depth of access.

Currently, GPs know in advance when they will be called by their PCT.

This has led to concerns that they are able to schedule their bookings around the call, to give the impression that they are meeting the two-day target, when it might be missed during the rest of the month.

Election issue

Prime Minister Tony Blair was confronted on the issue of GP appointment times in a BBC Question Time programme broadcast during last year's general election campaign.

Audience member Diana Church told Mr Blair she had been asked by her GP to bring her son back for an appointment in a week, only to be told by the receptionist that no bookings could be made more than 48 hours in advance.

Critics said the case showed that GPs were manipulating their bookings procedures to meet the government's 48-hour access target.

Announcing the new system, Health Minister Lord Warner said access to GPs had improved, and few patients now had to wait a week or more to see a doctor.

But he said in some cases there had been a difference between what patients report, and what the data on access to appointments showed.

He said "All patients should have fast access to a GP every working day of the month.

"At the same time, practices need to offer advance appointments. There must be no excuses or exceptions."

Doctors' doubts

Dr Hamish Meldrum, chairman of the BMA's GP Committee, said the change would have little impact on the practicality of the 48-hour target.

"Doctors will always see patients with an urgent medical problem straight away.

"However there can be problems with the 48-hour access target because it does not allow doctors to prioritise their patients on the basis of need, particularly at busy times.

"If you have to make more appointments available on the day or following day that means there are less appointments available for forward booking, particularly in under-doctored areas."

Michael Summers, of the Patient's Association, said the random PCT checks would achieve more if they were anonymous.

"Most GPs are reasonably honest about their returns, although there are some perhaps who are not as forthcoming as we would all like."

PCTs reported to the Department of Health in July 2005 that more than 99% of patients had the opportunity to be seen by a GP within two days, or a primary care professional within a day.

However, a patient survey carried out by the Healthcare Commission reported two months later than 12% of patients had been unable to see a GP within 48 hours.